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Bolton Community Education Foundation, Inc.
Education for the Entire
Community of Bolton, Connecticut
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Grant
Application Form
Please print out this form and
complete it in legible handwriting. Or you may highlight the form, copy
it, and paste it into a word-processing program for electronic
completion. You also may download a pdf
version of this form by clicking here.
Each applicant MUST SUBMIT TWO (2)
COPIES OF THE COMPLETED APPLICATION FORM, together with any supporting
materials, to:
Bolton
Community Education Foundation
c/o Pam Cropley
27 Stonehedge Lane
Bolton,
CT
06043
Please note that the determination
to fund a program and the amount of such funding, if any, rests
exclusively with the BCEF. Not all grant applications, regardless of
merit, can be funded.
If you would like more information
on applying for a grant, please contact the Bolton Community Education
Foundation at info@boltonedfoundation.org.
Application
#: ___________ (For internal use only)
Applicant Information:
1. Applicant’s Name:
2. Home Phone:
3. Professional Affiliation:
4. Program Title and Subject Area:
5. Proposed Program Location:
6. Date of Application:
By signing below, the applicant hereby (a) agrees to secure all required
approvals from the town or Board of Education which relate to the
completion of the program; (b) agrees to submit a post-project
evaluation to the Bolton Community Education Foundation; (c) grants the
Bolton Community Education Foundation the right to use this application
and the results of this project, if funded, for public information and
to help other foundations; and (d) understands that the Bolton Community
Education Foundation is solely a funding conduit and takes no liability
or other responsibility for the program or its execution.
______________________________________________
Applicant’s Signature
Please
complete all the referenced information in order to facilitate the
evaluation of the proposal.
Program Information:
7. Overview:
Briefly describe your program.
8. Objectives:
State specifically what your program will accomplish.
9. Plan of
Action: Describe the curriculum as it will progress.
10. Timeline:
Provide a timeline for the program.
11. Who are your
target participants and approximately how many students are you planning
for?
12. Rationale:
Why do you think there is a
specific need for this program?
13. Given the
stated criteria, explain why you think your program should be selected
for funding.
14. Evaluation: Describe your
plans for evaluating the program. (Evaluation methods can be as
simple as facilitator observation of participant attitude and enjoyment,
to more objective results or a measurement of skills attained as a
result of the program, surveys of attendees’ perceptions of the
program or a specific performance or exhibit.)
Funding Information:
15.
Amount of Grant Request:
16. Total
Estimated Cost of Project
17.
Budget: On a separate page,
please provide a budget or other itemized details of the cost of the
project and all the sources which you intend to use to meet these costs.
These costs may include a facilitator stipend, materials, supplies,
refreshments, etc. Please indicate whether you plan to charge
participants to attend this program, and whether participants must
supply tools or materials to participate.
18. Are
other
funds available to pay for this project? (If other funds are
available in addition to this grant, please describe what efforts you
have made to obtain such funds.)
Application
#: ___________ (For internal use only)
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